Patients who've been hurt in car or bike crashes, been shot or stabbed, or suffered other injuries are more likely to live if they arrive at the hospital on the weekend than during the week, according to new research.

Share This

Patients who've been hurt in car or bike crashes, been shot or stabbed, or suffered other injuries are more likely to live if they arrive at the hospital on the weekend than during the week, according to new University of Pennsylvania School of Medicine research published in the March 21 issue of Archives of Surgery. The findings, which also showed that trauma patients who present to the hospital on weeknights are no more likely to die than those who presented during the day, contrast with previous studies showing a so-called "weekend effect" in which patients with emergent illnesses such as heart attacks and strokes fare worse when they're hospitalized at night or on weekends.

Related Articles

The authors say the trauma system's unique organization and staffing appears to serve as a built-in protection for these critically injured patients, and may provide a roadmap for ongoing efforts to restructure and better coordinate U.S. emergency care, which needs to provide optimal care day or night.

"Whether patients have an emergent illness or a severe injury, the common denominator is time. Patients must rely on the system to quickly get them to the place that's best prepared to save their lives," says lead author Brendan G. Carr, MD, MS, an assistant professor in the departments of Emergency Medicine and Biostatistics and Epidemiology. "Trauma systems have been designed to maximize rapid access to trauma care, and our results show that the system also offers special protection for patients injured during periods that are known to be connected to worse outcomes among patients with time-sensitive illnesses."

Using data provided by the Pennsylvania Trauma Systems Foundation, Carr and senior author Douglas J. Wiebe, PhD, an assistant professor of Biostatistics and Epidemiology, studied 90,461 patients who were treated from 2004 to 2008 at Pennsylvania's 32 accredited trauma centers. About a quarter of the patients presented to the hospital on weeknights (defined as 6 p.m. to 9 a.m. Monday through Friday) and about 40 percent arrived on weekends (6 p.m. Friday to 9 a.m. on Monday). In addition to the survival-related findings, neither the weekend or night patient group experienced delays for crucial brain or abdominal surgeries often required for trauma patients, compared to weekday patients.

Across the United States, trauma patients are cared for by a regionalized system dictating that they be brought to facilities that meet strict requirements for round-the-clock staffing and capabilities for emergency medicine, radiology, surgery, and post-operative intensive care. Unlike most other medical and surgical specialties -- in which staffing and resources vary on nights and weekends -- trauma centers like the Hospital of the University of Pennsylvania are required to have these resources immediately available 24 hours a day, seven days a week, 365 days a year.

In addition to the constant presence of specialty staff, the authors suggest that the greater odds of survival on weekends uncovered in the study may be influenced by hospital scheduling factors. Since elective surgeries are typically not performed over the weekend, there is less competition for practitioners' time, operating rooms, blood bank, pharmacy and other hospital resources -- perhaps leading to expedited care for trauma patients during those times.

Despite the indication that trauma patients may, overall, be safer during off hours, the findings revealed that both weeknight and weekend presentation was associated with longer intensive care unit stays, and those who came to the hospital on weeknights were more likely to have a longer hospital stay overall than those who were admitted on a weekday. The authors suggest this may also be due to hospital factors not entirely related to the patient's condition, including greater bed availability because few elective admissions and surgeries occur on weekends.

Although the findings focus on injury outcomes and don't directly address care for other time sensitive conditions, the authors believe they offer solutions for improving care for all emergency patients. "There are complex questions that need to be addressed about our expectations around emergency care," Carr says. "It is unrealistic to think that all hospitals can be fully staffed to provide optimal care for all time-sensitive conditions all of the time, so our challenge is to develop an integrated system of emergency care for unplanned -- but inevitable -- critical illness. The trauma system has a plan of care in place long before we ever need it, and it offers many lessons for the remainder of emergency care."

University of Pennsylvania School of Medicine. "Trauma patients protected from worse outcomes associated with so-called 'weekend effect'." ScienceDaily. ScienceDaily, 21 March 2011. <www.sciencedaily.com/releases/2011/03/110321162012.htm>.

University of Pennsylvania School of Medicine. (2011, March 21). Trauma patients protected from worse outcomes associated with so-called 'weekend effect'. ScienceDaily. Retrieved March 3, 2015 from www.sciencedaily.com/releases/2011/03/110321162012.htm

University of Pennsylvania School of Medicine. "Trauma patients protected from worse outcomes associated with so-called 'weekend effect'." ScienceDaily. www.sciencedaily.com/releases/2011/03/110321162012.htm (accessed March 3, 2015).

More From ScienceDaily

More Health & Medicine News

Featured Research

Mar. 3, 2015 — Why do people shake hands? A new study suggests one of the reasons for this ancient custom may be to check out each other's odors. Even if we are not consciously aware of this, handshaking may ... full story

Mar. 3, 2015 — Doctors write millions of prescriptions a year for drugs to calm the behavior of people with Alzheimer’s disease and other types of dementia. But non-drug approaches actually work better, and carry ... full story

Mar. 3, 2015 — Briefly counseling college students on the dangers of binge drinking is effective in lowering heavy drinking levels among many students, but only temporarily. Three out of four will be right back ... full story

Mar. 3, 2015 — Body mass index in healthy adolescents has a statistically significant association with both systolic blood pressures and diastolic blood pressures, research shows, and it highlights the significance ... full story

Mar. 3, 2015 — Loneliness brought about by the death of a spouse can trigger a wider network of depression-like symptoms, a study has found, but authors suggest that doctors are often too quick to attribute these ... full story

Mar. 3, 2015 — Family Based Interpersonal Psychotherapy (FB-IPT) is more effective in treating preadolescent children with depression compared to child-centered therapy (CCT), a recent study has found. ... full story

Mar. 3, 2015 — Two of the four known groups of human AIDS viruses (HIV-1 groups O and P) have originated in western lowland gorillas, according to new research. The scientists conducted a comprehensive survey of ... full story

Mar. 3, 2015 — Scientists have succeeded in producing cartilage formed from embryonic stem cells that could in future be used to treat the painful joint condition osteoarthritis. With their huge capacity to ... full story

Mar. 3, 2015 — Everyone worries about losing their memory as they grow older—memory loss remains one of the most common complaints of the elderly. But the molecular reasons behind the processes remain unclear, ... full story

Featured Videos

Mom Triumphs Over Tragedy, Helps Other Families

AP (Mar. 3, 2015) — After her son, Dax, died from a rare form of leukemia, Julie Locke decided to give back to the doctors at St. Jude Children&apos;s Research Hospital who tried to save his life. She raised $1.6M to help other patients and their families. (March 3)
Video provided by AP

Woman Convicted of Poisoning Son

AP (Mar. 3, 2015) — A woman who blogged for years about her son&apos;s constant health woes was convicted Monday of poisoning him to death by force-feeding heavy concentrations of sodium through his stomach tube. (March 3)
Video provided by AP

Related Stories

May 31, 2014 — A systematic review and meta-analysis of hospital data worldwide adds further evidence that patients admitted to hospital at weekends have higher mortality than those admitted on weekdays. The ... full story

May 14, 2014 — People hospitalized with COPD or pneumonia are more likely to die during a weekend stay in hospital, according to a new study, the first to assess death rates among patients staying in hospital over ... full story

Feb. 4, 2014 — People seriously injured by violence are no more likely to die in the years after they are shot, stabbed or beaten than those who are seriously injured in accidents, researchers have ... full story

Aug. 10, 2012 — A review of more than 38,000 patient records finds that older adults who sustain substantial head trauma over a weekend are significantly more likely to die from their injuries than those similarly ... full story

ScienceDaily features breaking news and videos about the latest discoveries in health, technology, the environment, and more -- from major news services and leading universities, scientific journals, and research organizations.